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Int Poster J Dent Oral Med 13 (2011), No. 1     15. Mar. 2011

Int Poster J Dent Oral Med 2011, Vol 13 No 1, Poster 521

A 3-year clinical evaluation of the removable partial dentures attachments

Language: English
 

Authors:
Assist. Prof. Luciana Goguta, DDS, PhD, Assist. Prof. Anca Jivanescu, DDS, PhD,
University of Medicine and Pharmacy "Victor Babes", Faculty of Dentistry, Department of Prosthodontics, Timișoara, România
Marian Ana, DDS,
Private Practice, Timișoara, România
Corina Mărcăuţeanu, Lecturer, DDS, PhD,
University of Medicine and Pharmacy "Victor Babes", Faculty of Dentistry, Department of Occlusion, Timișoara, România

Date/Event/Venue:
22-25 April 2010
15th Congress of the BaSS 2010
I. Vellidis Congress Centre, Thessaloniki, Greece
 

Introduction

Removable partial dentures using attachments are aesthetic alternatives for edentulous patients with good retention and stability. There are many patients which cannot afford implant retained dentures or their physical condition do not allow us to treat them using implants. In these cases, removable partial dentures using attachments are good treatment alternatives.
 

Objectives

The aim of our study was to evaluate which of the attachments has been used more frequent and also to assess the patient satisfaction regarding each of these attachments.
 

Material and Methods

In this study the evaluated attachments were extra - coronal attachments, retentive ball attachments, telescopic crowns - retained removable partial dentures, bar clip attachments and magnetic retention. The number of the attachments was 267 and the surveying period was 3 years. The oral surveys were carried out by calibrated dentists in the Department of Prosthodontics, Timișoara, România in 2006-2009. The evaluation included the type of the partially edentulous arches, the type and the number of the attachments and the patients satisfaction regarding aesthetics, retention and stability during mastication and speech. Statistical analysis was performed for these evaluations. Each patient has signed and Informed Consent according to the Ethical Committee of our University (World Medical Association Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects). The maxillar and mandibular edentations were as in Tab. 1.
 

Kennedy Clasification Maxillary - 53 Mandibular - 57
Kennedy I 110 Kennedy 1 - 13 Kennedy 1 - 24
Kennedy I modif 1 - 21 Kennedy I modif 1 - 25
Kennedy I modif 2 - 10 Kennedy I modif 2 - 9
Kennedy I modif 3 - 8 Kennedy I modif 3 - 0
Kennedy II 73 Kennedy 2 - 1 Kennedy 2 - 2
Kennedy II modif 1 - 20 Kennedy II modif 1 - 6
Kennedy II modif 2 - 17 Kennedy II modif 2 - 17
Kennedy II modif 3 - 2 Kennedy II modif 3 - 5
Kennedy III 36 Kennedy 3 - 0 Kennedy 3 - 0
Kennedy III modif 1 - 15 Kennedy III modif 1 - 10
Kennedy III modif 2 - 2 Kennedy III modif 2 - 4
Kennedy III modif 3 - 5 Kennedy III modif 4 - 0
Kennedy IV 0 0 0
Table 1: Maxillary and mandibular distribution of the edentulous arches

Results

The most frequently used attachments were the extra-coronal attachments (58,6%), followed by the ball attachments (24,4%), the telescopic crowns (11,05%), the bar clip attachments (4,6%) and finally the magnets (0,18%) (Fig. 2). The evaluated attachments have advantages and disadvantages in different clinical situation. Patients satisfaction was very good and good in most of the treated patients (Fig. 3). Patient satisfaction improved significantly between baseline and the new prosthesis with each attachment type for all domains of satisfaction (P < 0.05).

Fig.2 Maxillary metal frame removable partial denture with extra-coronal attachments (1-7)
Removable partial dentures Mastication Aesthetics Stability
Good Accept Poor Good Accept Poor Good Accept Poor
extra - coronal attachments 9 9 9
retentive ball attachments 6 8 8
telescopic crowns 6 8 7
bar clip attachments 5 8 6
magnetic retention 4 8 6
Table 2: Patients satisfaction / type of attachment
 

Conclusions

The mostly used attachments in this study were the extra-coronal attachments because these are easy to use and they fit well to the clinical situation (Kennedy classification of partially edentulous arches). All the attachments used in this study were well accepted by the patients because of their good aesthetic and retention. Many of the patients included in the study mentioned that the galvanic telescopic crowns are too expensive for them. Also, using magnets involves a delicate technology, that is why our technicians are reserved in using these attachments.
 

Literature

  1. Behr M, Kolbeck C, Lang R, Hahnel S, Dirschl L, Handel G. Clinical performance of cements as luting agents for telescopic double crown-retained removable partial and complete. Int J Prosthodont, 2009, 22(5), pp. 479-87.
  2. Bratu Dorin, Emanuel Bratu, Sergiu Antonie. Restaurarea Edentaţiilor Parţiale prin Proteze Mobilizabile: Ed. Medicală Bucureşti, 2008, pp 361-427.
  3. Burns DR, Ward JE. A review of attachments for removable partial denture design: Part 2. Treatment planning and attachment selection. Int J Prosthodont 1990, 3(2), pp. 169-74.
  4. Burns DR, Ward JE. Review of attachments for removable partial denture design: 1. Classification and selection. Int J Prosthodont 1990, 3(1), pp 98-102.
  5. Khan SB, Geerts GA. Aesthetic clasp design for removable partial dentures: a literature review. SADJ, 2005, 60(5), pp.190-4.
  6. Wolf K, Ludwig K, Hartfil H, Kern M. Analysis of retention and wear of ball attachments. Quintessence Int. 2009, 40(5), pp. 405-12.
  7. Wöstmann B, Balkenhol M, Weber A, Ferger P, Rehmann P. Long-term analysis of telescopic crown retained removable partial dentures: survival and need for maintenance. J Dent 2007, 35(12), pp. 939-45.
  8. Zitzmann NU, Rohner U, Weiger R, Krastl G. When to choose which retention element to use for removable dental prostheses. Int J Prosthodont 2009, 22(2), pp. 161-7.
     

This Poster was submitted by Assist. Prof. Luciana Goguta, DDS, PhD.
 

Correspondence address:
Assist. Prof. Luciana Goguta, DDS, PhD
University of Medicine and Pharmacy "Victor Babes"
Faculty of Dentistry, Department of Prosthodontics
Bd. Revoluţiei, Nr. 9
Timișoara, 300041
România